{Reference Type}: Journal Article
{Title}: [Current research of sympathetic ophthalmia].
{Author}: Di Y;Ye JJ;
{Journal}: Zhonghua Yan Ke Za Zhi
{Volume}: 53
{Issue}: 10
{Year}: Oct 2017 11
暂无{DOI}: 10.3760/cma.j.issn.0412-4081.2017.10.013
{Abstract}: Sympathetic ophthalmia (SO) is a rare, bilateral, non-necrotizing, granulomatous uveitis that usually occurs after open ocular injury or intraocular surgery. The pathophysiology is not clearly understood, but generally SO is an immediate hypersensitivity mediated by T lymphocytes which are related to ocular tissue antigens. The main histopathological features are granulation tissues composed of lymphocytes, macrophages and multinucleated giant cells. The clinical manifestations are different from person to person, which might be mild or severe. Although it could be presented with anterior uveitis, intermediate uveitis and posterior uveitis, panuveitis is the most common sign. The ophthalmic examinations, such as fundus fluorescein angiography, optical coherence tomography and B-scan, could be used to observe the patients' conditions and monitor the therapeutic effect. The main treatment of SO is medical therapy with corticosteroids, immunomodulators and biomodulators. Topical drug administration, including intravitreal injection of triamcinolone acetonide and implantation of a fluocinolone acetonide implant, can be considered. There is controversy about whether enucleation or evisceration is more appropriate and when the procedure should be done. The prognosis of SO could be poor. SO is liable to deteriorate and may lead to blindness. This article reviews the etiology, mechanisms, histopathology, clinical characteristics, diagnosis and treatment of SO. (Chin J Ophthalmol, 2017, 53:778-782).<BR>交感性眼炎是一种少见的双眼非坏死性肉芽肿型葡萄膜炎，主要发生于穿透性眼外伤或内眼手术后。其发病机制尚不明确，目前认为是眼组织抗原诱发的T淋巴细胞介导的迟发型超敏反应。主要的组织病理学改变为形成由淋巴细胞、巨噬细胞及多核巨细胞组成的肉芽组织。临床表现或轻或重，症状和体征因人而异，可发生前、中、后葡萄膜炎，以全葡萄膜炎多见。临床上采用荧光素眼底血管造影术、相干光层析成像术、B型超声波等辅助检查观察患者病情，同时监测治疗效果。主要的治疗方法为药物治疗，药物包括糖皮质激素、免疫抑制剂及生物制剂。近年出现玻璃体腔或球侧曲安奈德注射、氟氢松眼内植入等新的用药方式。手术治疗的时机及术式选择存在争议。交感性眼炎的临床表现多变，病情容易反复恶化，预后较差，若未得到及时的诊断和有效的治疗，最终可致盲。本文将对交感性眼炎的病因、发病机制、组织病理学改变、眼部临床表现特点、诊断及治疗进行综述，为临床工作提供参考。（中华眼科杂志，2017，53：778-782）.